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Nitazene: What’s Going on With This Dangerous New Drug?

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Medically Reviewed By: Diana Vo, LMFT

January 8, 2024 (Originally Published)

January 24, 2024 (Last Updated)

Table of Contents

The emergence of a new class of drugs known as nitazenes is causing growing alarm among health professionals. While encounters with these substances are not yet widespread, their potency — surpassing even that of fentanyl — poses significant risks.

The properties and potential uses of nitazenes are detailed in medical and pharmaceutical texts from that period. Consequently, clandestine laboratories have been able to source information about these compounds from historical pharmacological literature. Nitazenes are widely distributed via the dark web.

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The complexity of treating overdoses, often requiring multiple doses of naloxone, coupled with a general lack of awareness among healthcare providers about these drugs, means that it’s imperative to address this evolving healthcare challenge.

What Is Nitazene?

Developed in the 1950s for use as opioid analgesics but never commercially released, nitazenes remain largely unknown outside specialized academic circles. These compounds are many times stronger than morphine and fentanyl.

Among the 10 identified nitazene compounds, these are the most common:

  • Isotonitazene
  • Metonitazene
  • Etonitazene

DEA classifies these as Schedule I substances, indicating a high potential for abuse and no recognized medical use. Nitazenes usually appear as a white, yellow, or brown powder, or as a crystalline solid.

Nitazenes have been detected in substances like heroin, ketamine, counterfeit oxycodone tablets, and synthetic cannabinoids. Nitazenes can be consumed through inhalation, injection, or ingestion, and are known to trigger the following effects:

  • Pain relief
  • Euphoria
  • Relaxation
  • Stress alleviation
  • Fever
  • Itchiness
  • Sweating
  • Nausea
  • Vomiting
  • Slowed breathing

The first recorded detection of isotonitazene, a member of the nitazene family, in a biological sample was reported to EMCDDA (European Monitoring Center for Drugs and Drug Addiction) in July 2019. Since its initial detection, isotonitazene has been linked to more than 200 drug-related fatalities across the United States and Europe. That said, the actual prevalence of nitazene opioid may be higher than reported, as many testing facilities lack the capability to specifically test for nitazenes.

Dangers of The Nitazene Drug

Here are some of the dangers associated with the use of nitazene drugs:

  • High potency and overdose risk: Nitazene drugs are known to be significantly more potent than traditional opioids. This increased potency heightens the risk of overdose, which can be life-threatening. Opioid overdoses can lead to respiratory depression, coma, and death.
  • Challenges treating nitazene overdoses: Nitazenes, frequently combined with fentanyl and various other substances, remain relatively obscure, meaning that there is little information about reversing overdoses and understanding interactions with other drugs and alcohol. This lack of awareness creates challenges, as people often unknowingly consume nitazenes, leaving first responders and medical professionals to address overdoses without sufficient knowledge. While naloxone (Narcan) can treat these overdoses, the high potency of nitazenes and the potential for severe intoxication may mean that multiple doses of this medication are required.
  • Dependence and addiction: Like other opioids, nitazene drugs have a high potential for dependence and addiction. When someone who is dependent on nitazenes abruptly discontinues use, severe withdrawal symptoms may present. Opioid withdrawal can be physically and psychologically distressing. Symptoms include pain, nausea, vomiting, diarrhea, and severe cravings.
  • Unknown composition and purity: Nitazene drugs are produced illicitly, meaning that their composition and purity are often unknown. This uncertainty increases the risk of overdose and adverse reactions.
  • Harmful interactions with other substances: Nitazene drugs can interact dangerously with other substances, including alcohol, illicit drugs, and prescription medications. These interactions can increase the risk of adverse effects and overdose.
  • Potential for long-term health consequences: Chronic use of opioids is associated with long-term health issues like organ damage, cognitive impairment, and mental health disorders.
  • Legal risks: Possession and distribution of nitazene drugs are illegal, exposing people to potential legal consequences.
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Nitazene Potency vs. Fentanyl

While some nitazenes are reported to be more potent than fentanyl, the information available regarding their relative potency is limited and occasionally inconsistent. One review of studies involving 93 fatal cases where isotonitazene was found in the bloodstream indicates that nitazenes are as strong as fentanyl.

Overdose Deaths from Nitazene

In recent years, there has been an alarming rise in overdose deaths linked to synthetic opioids like nitazenes. This surge in fatalities highlights the urgent need for awareness and proactive measures in addressing this emerging threat.

Boulder County, Colorado, has experienced an uptick in nitazene-related fatalities, with at least two deaths since mid-2023, according to a December 2023 report – one of these cases involved a novel nitazene compound, something that merits further investigation.

This disturbing trend is not isolated to Colorado, though. Other states are also reporting an increase in nitazene incidents. For instance, Ohio observed a 19% surge in nitazene-related cases in the early part of 2022 compared to the same period of the previous year. Similarly, Tennessee witnessed a significant rise in fatalities due to nitazenes, with 42 deaths in 2021, set against just 10 lethal overdoses reported in 2020.

Treatment for Nitazene Addiction

Nitazene addiction requires a comprehensive and empathetic approach toward treatment that addresses the physical and psychological aspects of opioid use disorder. This often begins with supervised medical detoxification.

  • Medical detox: The first step in treating nitazene addiction involves withdrawing from opioids under professional supervision. This process safely manages the acute physical symptoms of withdrawal, minimizing the likelihood of complications or relapse disrupting early recovery.
  • Inpatient or outpatient rehab: Those with severe addictions, co-occurring mental health conditions, or unstable home environments typically benefit from inpatient rehab (residential rehab), remaining at a treatment center for 30 to 90 days. Outpatient programs, available at varying levels of intensity, enable individuals with milder addictions to engage with treatment while fulfilling everyday obligations. Both types of treatment offer access to similar services.
  • MAT (medication-assisted treatment): MAT combines FDA-approved medications like methadone, buprenorphine, or naltrexone with counseling and behavioral therapies. This holistic approach helps in reducing cravings and withdrawal symptoms, promoting ongoing abstinence.
  • Behavioral therapies: CBT (cognitive behavioral therapy) helps people understand and modify their thought patterns and behaviors related to opioid abuse. This form of psychotherapy is proven effective for treating opioid addictions.
  • Counseling: Counseling, in both individual and group settings, is a core component of nitazene addiction treatment.
  • Holistic therapies: Incorporating holistic therapies like yoga, meditation, and mindfulness can enhance the recovery process and complement science-backed interventions. These therapies focus on the overall well-being of the individual, offering alternative ways to cope with stress and emotional turmoil.
  • Support groups and peer support: Engaging with support groups provides a sense of community and belonging. Sharing experiences and coping strategies with others who are facing similar challenges can be incredibly therapeutic and supportive.
  • Aftercare planning: Sustainable recovery from nitazene addiction involves careful aftercare planning. This includes ongoing therapy, support groups, and possibly sober living environments. Such measures help prevent relapse and provide continuous support in the ongoing recovery journey.

If you or someone that you care about is struggling with nitazene addiction, reach out for help today. Remember, recovery is possible, and it starts with taking that first step toward healing.


What are nitazenes?

Nitazenes are a class of synthetic opioids known for their potent analgesic effects. They were initially developed for medical use but are now often encountered as illicit substances, contributing significantly to the opioid crisis.

What is the potency of nitazene?

Nitazenes are remarkably potent, often exceeding the strength of traditional opioids like morphine and fentanyl. Their high potency increases the risk of overdose and severe dependency, making them particularly dangerous when abused.

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Get Treatment for Nitazene Addiction at Renaissance Recovery

While opioid use disorder is a chronic condition, we can help you achieve and maintain sobriety at Renaissance Recovery’s rehab in Huntington Beach, California.

Our intensive outpatient treatment programs enable you to engage with evidence-based addiction treatment without neglecting your everyday obligations. If you require help withdrawing from nitazenes safely, we can connect with licensed medical detox centers near you.

All opioid addiction treatment programs at Renaissance’s rehabs in Florida and California blend the following therapies for a personalized and whole-body approach to recovery:

  • MAT (medication-assisted treatment)
  • Psychotherapies (CBT and DBT) 
  • Motivational therapies
  • Family therapy
  • Group therapy
  • Individual counseling
  • Holistic interventions
  • Aftercare planning

Call 866.330.9449 today and begin your recovery from nitazene addiction right away.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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